TO DISCLOSE OR NOT TO DISCLOSE

Whether you’ve only just learned about your HIV positive status and it’s still fresh news that you are beginning to absorb or it’s something you have been living with for a while, there are bound to be many situations in your life in which you will be faced with the decision of whether or not to disclose your HIV status.

In a number of circumstances you will find yourself trying to balance honesty with protecting your right to privacy.

Whom do you feel you need to tell? Is there someone you want to tell, but aren’t sure what or how much to say? Is there anyone you feel that you must tell, like a spouse, a partner, or perhaps someone whom you’ve been dating? What about informing any sex partners you’ve been with about your status?

This is a difficult decision to make because disclosure (or not disclosing) can have significant consequences. As with so many of the important life decisions, there are no absolute answers that are right for everyone. It takes time to adjust to being HIV positive. With that in mind, it’s a good idea not to rush into disclosing your status without first giving it some thought.

Wanting to share this knowledge with someone else is a perfectly natural reaction, especially when it’s new to you and you’re feeling overwhelmed, vulnerable, and uncertain about your life and your future. The reality is that people with HIV need to be selective about disclosing. They need to be selective about who they tell and when they tell them. This process of selection often involves uncertainty and can sometimes be an anguishing experience.

Consider the benefits as well as the possible negative consequences that disclosure may have for you as an individual. Plan ahead before you disclose your HIV status so that you can feel in control of the process. It may be better to disclose gradually ﾖ to your partner, or to one trusted friend or to one member of your family you feel especially close to ﾖ rather than to everyone at once. You don’t have to tell everyone. The choice is yours about whom to tell. Be selective.

Be sure to consider these five words when thinking about disclosure: who, what, when, where and why. Who do you need to tell? What do you want to tell them about your HIV status, and what are you expecting from the person you are disclosing to? When should you tell them? Where is the best place to have this conversation? Why are you telling them?

Consider whether there is a real purpose for you to tell this person or if you are simply feeling anxious and want to “dump” your feelings. Telling people indiscriminately may affect your life in ways you haven’t considered. Having feelings of uncertainty about disclosing is a very common reaction in this situation. You have a virus. That doesn’t mean you’ve done anything wrong. You don’t have anything to apologise for simply because you are HIV positive.

Assess how much they know and understand about HIV. This will help you to decide what you need to tell the person and how to tell them. Being prepared will make disclosure less traumatic for both of you. Remember that many people are ignorant about HIV and may need additional information to help them understand your circumstances. When you do disclose your status to anyone remind them that this information is deeply personal and cannot be shared with others without your consent.

Openness about your HIV positive status may make it easier to negotiate responsible sex and to prevent others being infected. Many men find it very difficult to tell a potential new partner or lover that they are positive because they fear rejection. It is often easier to tell someone upfront before you have sex with them ﾖ if you tell them later they could feel that you betrayed them. Either way, being HIV positive makes you responsible for never putting anyone else at risk of being infected.

Some men find it easier to only have sex with other men who are also HIV positive, but this doesn’t mean you can stop using condoms. Sexually transmitted infections (STIs) such as syphilis, hepatitis or genital warts can be very serious for HIV positive men and must be avoided. Learn as much as you can about HIV, STIs and sexual health. Health4Men has an entire series of brochures that you can read that will help you to make informed decisions about sex and your sexual health. You can get these at any of their sites or read them online on their website.

If you are the friend or the person being disclosed to, remember that for this person it is an extremely difficult thing to do. Give the person who is disclosing to you the opportunity to talk and to listen. Asking questions about HIV is important as this will help you to learn and understand but try and be supportive and not offensive. “How did you get it?’’ for example should be avoided and rather ask “Have you started treatment yet?” or “Have you found a good doctor?” It will mean a lot to the person who is disclosing to you if you reassure them that you are there for them and that you will respect confidentiality. Remember that stigma is a by-product of fear and fear comes from the lack of knowledge. Gaining knowledge is the key to understanding and is a responsibility that everybody shares.

Avoid isolating yourself about your status. If you are still not able to tell close friends, family members or other loved ones about your HIV status, allow yourself to draw upon the support and experience available to you, through organized groups in the HIV community. Disclosure can help you to accept your own HIV positive status and can also help you to access the medical services, care and support that you need.

Health4Men currently has support groups for gay and bi men living with HIV in both Johannesburg and in Cape Town. For more information on the Johannesburg support group please mail group@anovahealth.co.za or call 011 715 5880. For details on the Cape Town support group please call 021 421 6127 or email to office@health4men.co.za. Alternatively please visit the Health4Men website on www.health4men.co.za and look under the psychosocial services section.

Health4Men is a project of the Anova Health Institute NPC and is funded by PEPFAR/USAID.